Medical Student Graduates: 1999-2000


.7% Puerto Rican (mainland) 

.8% American Indian/Alaska Native 

1.2% Puerto Rican (other) 

1.9% Other Hispanic 

2.8% Mexican American 

7.4% African American 

18% Asian/Pacific Islander 

67.1% 

All other students* 

*All other students includes white students (not of

Hispanic origin) and non-US citizen foreign stu

dents of various racial and ethnic backgrounds. 

How Do Physicians-in-Training


Become Culturally Competent?


Listen with sympathy and understanding to the patient’s perception of the problem. 

Explain your perceptions of the problem and your strategy for 

treatment. 

Acknowledge and discuss the differences and similarities between 

these perceptions. 

Recommend treatment while remembering the patient’s cultural 

parameters. 

Negotiate agreement. It is important to understand the patient’s 

explanatory model so that medical treatment fits in their cultural 

framework. 

Source: A Teaching Framework for Cross-Cultural Health Care. Berlin EA, 

Fowkes WC Jr, Western Journal of Medicine. 1983, 139:934-938. 

Data Source: Barzansky, B, Jonas, HS, and Etzel, SI. Education programs inUS medical schools, 1999-2000. JAMA. 2000;284:1114-1120. 

Racial & Ethnic Backgrounds of


-

Our Nation is growing more diverse. By 2010, minority reflect the characteristics of their institution and surrounding compopulations will constitute 32 percent of the U.S. popu­ munity and resources. lation. By 2050, nearly half of the U.S. population will be For example, Wake Forest University in North Carolina adapted 

composed of members of ethnic and racial minorities. In order to the PRIME curriculum to respond to the presence of Hispanic, 

become effective and responsible physicians, medical students need to Hmong, and American Indian populations that surround the school. 

learn to respond to the unique needs of patients from varying Speakers during the fall 2000 semester have focused on common 

ethnicities, races, sexual orientations, and cultural backgrounds. Medical cultural and demographic misconceptions of the above populations, 

schools have a responsibility to prepare their students for cross-cul­ as well as their important values and health beliefs. Students have 

tural relationships with their patients. given excellent feedback on the small group sessions, which last from 

In an effort to foster cultural competency curricula in medical two to four hours each and are led by physicians, community leaders, 

schools, the American Medical Student Association (AMSA), in con­ and Wake Forest faculty. 

junction with the Promoting, Reinforcing and Improving Medical The Medical University of South Carolina has adapted the 

Education (PRIME) project, funded by the U.S. Department of PRIME curriculum to reflect the unique population of South CaroHealth and Human Services, has developed a one-year pilot curricu­ lina, including migrant farm workers and the nearby Gullah commulum for addressing issues of diversity in medicine. nity. Noon-time presentations have attracted a much greater audience 

than expected, with 146 students attending a recent “Religious DiCulture and Diversity Pilot Curriculum versity” presentation. 

The University of Kansas School of Medicine has also incorpoThe educational goal of the Culture and Diversity curriculum is rated the PRIME goals into its medical school curricula. The school 

to provide a curriculum on cultural competency that will help physi­ focused its curricula on eliminating biases. Small group class sessions 

cians-in-training develop the attitudes, skills, and knowledge base to included discussions of the Tuskegee Project, obtaining a relevant and 

serve diverse populations effectively, especially underserved and vul­ complete cultural history, and the relationship between economics 

nerable populations. and health. 

The curriculum is based on specific core competencies that each The PRIME project also developed the Community Responsive 

school must address. Some of the core competencies include: cultural Curriculum Project, which focuses on teaching medical students the 

models of health, disease and illness, cultural/traditional health care skills necessary to be a physician in underserved areas. 

practices, negotiating cultural conflicts in the doctor-patient relation­ For more information on the PRIME curriculum projects, please go to 

ship, effective communicating and interviewing, and using interpret­ http://www.amsa.org/programs/prime.html or contact Shadia Garrison, 

ers. Medical schools participating in PRIME adapt the curriculum to PRIME Project Manager, at shadia_g@www.amsa.org.❖

Diversity Training in Medical School:


AMSA Tests Pilot Curriculum


Guest Editorial by Meredith Burke Lawler, American Medical Student Association


Closing the Gap, Cultural Competency Part II • February/March 2001


Office of Minority Health Resource Center U.S. Department of Health and Human Services